It’s natural to feel concerned if you experience any leakage of fluid during pregnancy. Small amounts of fluid leakage are usually nothing to worry about. However, it’s important to understand the possible causes of amniotic fluid leaks and when you need to see your doctor.
What is amniotic fluid?
Amniotic fluid is the protective liquid that surrounds your baby in the amniotic sac inside your uterus. It has several important functions:
- It cushions the baby from bumps and injury.
- It regulates temperature.
- It allows the baby to move freely.
- It facilitates lung development.
The amniotic sac and fluid also help protect your baby from infection. Your body continually produces amniotic fluid and the baby swallows it and passes small amounts in the urine. Most of the amniotic fluid is replaced every day.
What causes amniotic fluid leaks?
There are several possible explanations for leaking small amounts of fluid during pregnancy:
- Increased vaginal discharge – More vaginal discharge is common in pregnancy due to increased estrogen levels. It’s usually transparent, white, or off-white and feels wet or sticky.
- Urinary incontinence – Some pregnant women experience accidental urine leakage when coughing, sneezing, or laughing due to pressure from the uterus.
- Cervical fluid – The cervix produces more mucus-like discharge during pregnancy that can be expelled.
- Premature rupture of membranes (PROM) – A tear or hole can develop in the amniotic sac, causing a slow leak or sudden gush of amniotic fluid.
- Placental abruption – The placenta separates from the uterine lining, causing heavy bleeding that may appear with amniotic fluid.
When to see a doctor
It’s generally nothing to worry about if you notice just a few drops of thin, clear or pale yellow fluid. However, you should contact your doctor or go to the hospital right away if you have any of the following:
- Heavier leakage of fluid
- Thick, mucus-like, or foul-smelling discharge
- Fluid that’s red, pink, brown, or green-tinged
- Sudden gush or steady leaking of fluid
- Wetness that requires frequent pad changes
- Leaking associated with bleeding
- Leaking accompanied by abdominal pain and cramping
- No movement felt from the baby
- Signs of early labor
These may indicate a larger rupture of membranes or a serious complication that requires prompt medical care. Don’t hesitate to call your provider even if you are uncertain about the cause of fluid leakage.
When Leaking Fluid Warrants Immediate Attention
While small amounts of fluid discharge may be harmless, certain symptoms require an urgent trip to the hospital. Here are some signs that prompt medical evaluation is needed:
Heavy fluid leakage
More than just a few drops or a trickle of amniotic fluid leaking likely signals a larger rupture in the amniotic sac. This is known as premature rupture of membranes (PROM). It occurs in about 8% of pregnancies and requires medical assessment to check for complications.
Gush of fluid
A sudden gush of fluid from the vagina may represent a significant PROM. Most cases of PROM involve a steady trickle, so a substantial gush of fluid is worrisome. Time contractions if they occur, as you may be going into labor.
Persistent leaking
If you need to wear pads that are soaked frequently, it suggests an ongoing fluid leak rather than just occasional drops of fluid. Persistent leaking needs evaluation to determine if your membranes have ruptured and how much fluid remains.
Thick, mucus-like discharge
True amniotic fluid is thin and mostly colorless. Thick, sticky, or mucus-like discharge more likely represents cervical fluid or secretions, but should be checked.
Foul-smelling fluid
Amniotic fluid typically has a mild, sweet odor. Foul-smelling fluid suggests vaginal infection, dehydration, or more seriously, chorioamnionitis. Chorioamnionitis is an infection of the placental and amniotic fluid tissues that can be life-threatening.
Bloody or brown-tinged fluid
Red, pink, or brownish fluid indicates blood is mixing with the leaking amniotic fluid and needs prompt assessment. Causes may involve placenta abruption, trauma, infection, or other complications.
Fluid with contractions or cramping
Regular uterine contractions along with any amount of fluid leakage may signal preterm labor. Contractions every 5-10 minutes paired with lower back pain require immediate evaluation.
No fetal movement
Lack of expected fetal activity needs quick follow up. Decreased amniotic fluid level from membrane rupture reduces fetal movements.
Signs of preterm labor
Preterm labor starting before 37 weeks may cause PROM in addition to contractions, pelvic pressure, low backache, abdominal cramps, and vaginal bleeding. Prompt hospital assessment helps determine if labor can be stopped or delayed.
What Happens If You’re Leaking Amniotic Fluid?
If you suspect you’re leaking amniotic fluid, call your healthcare provider or go to labor and delivery at the hospital for evaluation. Here’s what you can expect:
Medical history and symptom review
The doctor will ask about your symptoms, the color and amount of discharge, if you’re having contractions, and other medical factors. Telling how long you’ve had leakage, any associated symptoms, and if it’s changed recently is helpful.
Sterile speculum exam
A pelvic exam lets providers visually check for fluid leaking from the cervix and collect samples for testing. They will use a sterile speculum to avoid introducing bacteria.
Fluid tests
Samples of vaginal fluid may be evaluated in the lab to detect insulin-like growth factor binding protein and placental alpha-microglobulin-1 found in amniotic fluid. Testing pH also helps diagnose rupture of membranes.
Ultrasound
Imaging your uterus and amniotic sac can detect low fluid levels signaling membrane rupture. Your baby’s size and position may also be checked.
Fetal monitoring
Monitoring your baby’s heart rate for accelerations and reactivity provides information on well-being and the potential need for delivery.
White ring test
Placing a swab in your vagina for an hour to check for ferning patterns and drying suggests the presence of amniotic fluid.
Treatment
If tests confirm leaking amniotic fluid, your doctor will discuss options for induction, monitoring, medications, or possible early delivery if nearing term. Hospitalization may be recommended.
What to Do If You’re Leaking Fluid
Coping with potential leakage of amniotic fluid can be anxiety-provoking. Here are some tips for responding appropriately:
Notice symptoms
Pay attention to the sensations you feel, color of discharge, amount, odor, and if you need pads. Note any associated signs like bleeding, cramping, or reduced fetal movement.
Avoid sexual intercourse
Prevent introducing any bacteria into the vagina when fluid leakage is present, as it may signify an opening into the amniotic sac.
Call your doctor or labor unit
Contact your provider about symptoms for guidance on next steps. Go to labor and delivery at the hospital if advised or if worried.
Bring extra pads or adult diapers
Heavy leakage may require frequent pad changes so bring extras. Adult diapers can help contain large amounts of fluid.
Wear panty liners
For smaller discharge, panty liners help monitor ongoing leakage without as much bulk as pads.
Note if you’re contracting
Time any uterine contractions and notify your doctor if they are regular, frequent, and accompanied by leaking fluid.
Monitor baby’s movements
Use kick counts or a fetal monitor to check your baby’s activity level and make sure it remains consistent.
Be ready to describe your symptoms
Healthcare providers will ask details about the discharge, so be prepared to describe it accurately to aid diagnosis.
Seek emergency care for heavy bleeding
Fluid with bright red blood or clots needs immediate ER evaluation, as it may indicate abruption or uterine rupture.
When Leaking Fluid Is Nothing to Worry About
You don’t need to panic about every drop of moisture you notice during pregnancy. Here are some common scenarios where light leaking of fluid is usually not concerning:
Occasional trickle of thin, clear or pale discharge
Normal pregnancy discharge varies, so a small amount of watery leakage now and then is no cause for alarm. Just observe to see if it becomes heavier.
White or off-white mucus-like secretion
Increased cervical mucus is common in pregnancy and not necessarily amniotic fluid unless very heavy or tinged with blood.
Leakage only noticed when bearing down
Stress incontinence when sneezing or coughing typically causes minor urine leakage, not amniotic fluid. Kegel exercises may help strengthen pelvic muscles.
Sudden wet sensation that stops
Sometimes prolonged pressure on the bladder from your baby’s position causes a small accidental urine release that then ceases. Changing positions can help.
Moisture after intercourse or vaginal exam
It’s normal to have wetness from cervical fluids, semen, or lube after sex or an internal checkup. This usually clears shortly.
No accompanying symptoms
If you have no contractions, cramping, bleeding, or other signs of complication, light leaking alone is less concerning. Still mention it to your provider.
Negative fluid checks in hospital
If you visited your healthcare provider for evaluation and tests found no amniotic fluid leakage, occasional dampness is likely discharge.
Only need panty liner for moisture
Needing just a liner and not frequent pad changes suggests only light vaginal secretions are present, not excessive amniotic fluid.
FAQs About Leaking Amniotic Fluid
Here are answers to some frequently asked questions about leaking amniotic fluid and discharge during pregnancy:
How often do membranes rupture before labor starts?
Premature rupture of membranes (PROM) occurs in about 8-10% of term pregnancies and about 2-4% of preterm pregnancies. For most women, membranes rupture at the onset of active labor.
Does fluid color matter?
True amniotic fluid is usually clear with a pale yellow or straw color. Fluid that is bright yellow/green, brown, or red-tinged needs prompt evaluation as it likely indicates infection, blood, or meconium.
What’s the most common gestational age for PROM?
Most PROM cases occur between 37-38 weeks gestation, with an average interval of 8-12 hours between membrane rupture and labor onset in term pregnancies.
Can you have PROM without contractions?
Yes, it’s possible to have rupture of membranes without going into active labor right away. However, contractions often start within a day or two.
How often does PROM require delivery?
About 95% of women with PROM before 37 weeks end up delivering within 1 week. For PROM after 37 weeks, about 80% deliver within 24 hours and nearly all within 48 hours.
What amount of fluid leakage is concerning?
Any sizable gush of fluid or steady leaking that flows out with movement or standing up should prompt urgent assessment for membrane rupture.
Does my water have to break for labor?
No, your “water breaking” or full rupture of membranes may not occur until after you enter active labor and begin pushing, or your doctor may artificially rupture membranes during labor.
Can membranes reseal after rupturing?
In rare cases, a small puncture site in the amniotic sac may temporarily seal off with a blood clot or vernix plug, but membranes don’t fully mend once significantly ruptured.
How much amniotic fluid should be left?
Ideally, you should have at least 5-6 cm of amniotic fluid measured around your baby on ultrasound. Oligohydramnios refers to very low fluid volume under 5 cm.
What are warning signs with PROM?
Signs of potential complication with PROM include foul odor, fever, heavy bleeding, cord prolapse, placental abruption, and uncontrolled labor causing possible cord compression.
Conclusion
In summary, many pregnant women experience episodes of light watery discharge or wetness that are usually normal. However, prompt medical assessment is required if you have heavier leaking, gushing, or other symptoms that could signal preterm premature rupture of membranes or other complications. Don’t hesitate to contact your healthcare provider right away if you have any concerns about leaking amniotic fluid. With evaluation and monitoring, issues like PROM can often be managed safely.